JPS5823105B2 - Catheter guide wire - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a guide wire for guiding a catheter when introducing the catheter into a body cavity such as a blood vessel.

A method is known in which a contrast medium is injected into a desired blood vessel using a catheter, and the state of the blood vessel is imaged using X-rays.

In this method, it is necessary to insert a catheter for contrast medium injection into the blood vessel to be imaged in advance, but
The catheter is inserted using the previously inserted guide wire as a guide.

However, the conventional guide wire has a wide range of width (the guide wires used are straight or have only a curved tip, so to speak, they are fixed), so they are inserted into the blood vessel and then inserted into the vascular system. It was not possible to adjust the curvature state to suit the state of the object.

Therefore, difficulties often arise when selecting a specific blood vessel to place a catheter.

Therefore, recently, a guide wire has been developed whose distal end can be freely bent by operating it on the proximal side even after being inserted into a blood vessel.

In other words, this guide wire is constructed by connecting the tip of a traction wire inside a flexible tube to one side wall of the tip of the flexible tube, and bending the tip by pulling the traction wire on the proximal side. It is.

It is true that this guidewire has made it possible to easily perform selective angiography, but it has the following drawbacks.

(1) Since the tip side wall of the flexible tube is pulled by a pulling wire, the angle at which it can be bent is within 90°, and an angle close to 90° is rather unreasonable.

(2) Because the tip is bent by pulling a thin traction wire, the thin traction wire may often break during work.

(3) If the flexible tube is curved in the middle, the traction force of the traction wire is difficult to be transmitted to the tip of the flexible tube, and
The stronger the traction, the more likely the traction wire will break.

(4) Traction force when performing the bending operation of the tip.

This can easily lead to erroneous operation (dangerous).

The present invention has been made in view of the above-mentioned circumstances, and its purpose is to provide a catheter guide wire that can have a large curvature angle at the distal end and that can be used safely without requiring a large operating force. Our goal is to provide the following.

That is, the present invention comprises: a guide outer tube having an outer diameter that allows insertion into a catheter and having at least a bendable tip; a correction pipe inserted into the outer tube so as to be freely retractable; A core metal is provided which is inserted into the straightening pipe and whose tip is attached and fixed to the tip of the outer guide tube, and the tip of the core metal has a characteristic of being curved, so that the straightening pipe can be moved forward and backward. The present invention provides a catheter guide wire that is equipped with a hand-operated operating section.

be.

Embodiments of the present invention will be described below based on the drawings.

Reference numeral 1 in FIG. 1 is a part of the guide wire, and the operating part 2 is attached to and dislocated at the proximal end of the guide wire part 1.

It is currently installed.

As shown in FIG. 2, the guide wire part 1 has a straightening pipe 4 inserted into a flexible outer guide tube 3, and a core wire 5 passing through the straightening pipe 4. It is what it is.

The guide outer tube 3 has a tightly wound elastic coil spring 6.
9. To curve 90 degrees with a radius of curvature of 6 mm.
It requires 1g of force.

The wire I of the elastic coil spring is a stainless steel wire with a diameter of 0.15 mm.

The length of the outer guide tube 3 is 1.5 m, and its outer diameter allows the catheter 8 to be inserted therein.

For example, it is formed to have a thickness of 1.0 mm.

Further, a tip member 9 made of a brazing material such as solder or silver solder is embedded in the tip of the outer guide tube 3, and the tip of the core wire 5 is embedded and fixed in the tip member 9.

The straightening pipe 4 has an inner diameter of 0.38 mm, for example.

It is made of stainless steel with an outer diameter of 0.5 mm and has a length of about 1.3 m, and is inserted so that it can move independently in the front and back directions within the outer guide tube 3.

Further, the straightening pipe 4 may be made of Teflon.

Although the straightening pipe 4 can be curved, it has sufficient strength to straighten the crookedness of the core wire 5, which will be described later.

In addition, a stopper 10 is provided on the outer periphery of the base end of the straightening pipe 4.
is provided protrudingly, and when the straightening pipe 4 is advanced,
The stopper 10 is adapted to come into contact with the rear end of the outer guide tube 3.

Then, when the stopper 10 hits the rear end of the outer guide tube 3, the tip of the straightening pipe 4 does not reach the tip member 9 of the outer guide tube 3, but rather leaves an interval l. .

Therefore, even when the straightening pipe 4 is inserted all the way, the leading end portion 11 of the outer guiding tube 3 can be freely bent without being affected by the straightening pipe 4.

That is, the leading end portion 11 of the outer guiding tube 3 is always flexible and curved.

The core wire 5 has an outer diameter of 0.3 mm, and is composed of, for example, 19 stainless steel wires each having a diameter of 0.06 mm twisted together. The residual stress for this bend was 13.1.9 at 90° when it was bent in a cantilevered manner on a circular arc with a radius of curvature of 6 degrees.

When the straightening pipe 4 is retreated as shown in FIG. 3, the part protruding from the tip of the pipe 4 curves from itself
When the distal end 13 of the outer guiding tube 3 is bent, for example, in a circular arc with a radius of curvature of 6 mm, the bend is made with the base point at about 9 mm from the distal end.

In other words, the bend in the tip 12 of the core wire 5 can be straightened by surrounding it with the straightening pipe 4, but if the straightening pipe 4 is pulled out, the exposed portion will be curved and guided by its restoring force. The distal end portion 13 of the external tube 3 can be curved.

Therefore, by adjusting the amount of movement of the straightening pipe 4, the amount of curvature of the distal end portion 13 of the outer tube 3 can be adjusted.

Further, an engaging piece 1 as shown in FIG. 4 is attached to the base end of the core wire 5.
4 has a fixed installation.

The height of this engaging piece 14 from the center is the same as the height of the straightening pipe 4.

That is, the catheter 8 can be inserted freely.

On the other hand, the operation section 2 is configured as shown in FIG.

That is, the front end 16 of the operating section main body 15 is formed with a tip 18 into which a fastening cap 1T, which will be described later, is removably screwed, and this front end 16 has an insertion hole through which the straightening pipe 4 is inserted. 119 is formed.

The inner diameter of the insertion hole 19 is set so that the stopper 10 of the straightening pipe 4 can also pass therethrough.

However, by setting the outer diameter of the outer tube 3 to be small, the outer tube 3 cannot be passed through.

Further, the fastening cap 17 is screwed onto the tip 16 of the operating section main body 15, and therefore, a thread 20 is formed on the outer periphery of the tip 16, and a fitting screw 21 is provided on the cap 17 side. It is formed.

Furthermore, a through hole 22 through which the outer tube 3 can be inserted is formed in the cap 17, so that the outer tube 3 can be inserted tightly therethrough.

Inside the cap 17, an elastic ring 2 for fastening is provided.
3 is stored.

The fastening elastic ring 23 has the same inner diameter as the through hole 22 in a normal state, so that the outer tube 3 can be inserted therethrough.

Furthermore, for this fastening. ring 23 is its cap 17
and the tip 16, and is compressed by screwing in the fastening cap 17, so that the inner diameter can be reduced.

That is, by tightening the cap 17, the outer tube 3 can be fastened and fixed.

Further, a round lock (registered trademark) 24 is formed at the tip of the fastening cap 17, and this tapered portion 2
By fitting the engaging portion 26 of the catheter 8 into the catheter 5 and screwing the engaging piece 28 into the screw-shaped engaging protrusion 27, the catheter 8 is removably locked.

Further, a locking portion 30 is formed at the rear end portion 29 of the operating portion main body 15 to removably lock the engaging piece 14 of the core wire 5 so as not to rotate.

That is, with the core wire 5 pulled backward, the engaging piece 14
is locked in the locking part 30, so that a constant light tension is applied as shown in FIG.

Therefore, when using the guide wire 1, the distal end 13 of the guide wire 1 is first placed in a blood vessel using the Seldinger technique.

Next, as shown in FIG. 5, the catheter 8 is inserted into the guide wire 1, and the engagement portion 26 of the catheter 8 is locked with the ground lock (registered trademark) 24.

At this time, the tip of the catheter 8 is located closer to the operating section than the tip 12 of the bent core wire 5.

Then, the outer tube 3 is inserted through the fastening cap 170 through hole 19 and the elastic ring 23, and the fastening cap 17
is tightened and held by the elastic ring 23.

In addition, since the outer tube 3 is larger than the inner diameter of the insertion hole 19,
It does not enter into the insertion hole 19.

Further, the core wire 5 reaches the rear end portion 29 of the operating section main body 15 and locks the engaging piece 14 to the locking portion 30.

Therefore, the core wire 5 is pulled with a constant light tension and is straight.

On the other hand, the straightening pipe 4 is advanced until the stopper 10 touches the rear end of the outer tube 3.

At this time, the rear end portion of the straightening pipe 4 is exposed in the operation section main body 15, and this portion can be moved forward and backward by hand.

For example, when attempting to guide the catheter 8 into the renal artery 31, the guide wire portion 1 is inserted from the thigh and passed through the aorta 31 into the renal artery 31 as shown in FIG.
Guide it to the branching point.

When the straightening pipe 4 that has been advanced is moved back when it reaches this branching part 33, the tip 12 of the core wire 5 is exposed from the straightening pipe 4 and bends due to its bending characteristics, as shown in FIG. The distal end 13 of the outer tube 3 is bent into a U-shape.

As described above, the amount of curvature can be adjusted by adjusting the amount of movement of the straightening pipe 4.

Furthermore, by rotating the operation section main body 15 on the hand side, the guide wire part 1 can be rotated together with this.

That is, the orientation of the guidewire portion 1 can be adjusted remotely.

Thus, while observing the state of the distal end 13 of the guide wire part 1 under the X-edge, the amount of curvature and direction of the distal end 13 is adjusted, and the distal end 13 is pushed toward the renal artery 32. can be inserted into.

After the catheter 8 is inserted deep into the renal artery in this manner, the engaging portion 26 of the catheter 8 is removed from the round lock (registered trademark) 24, and the catheter 8 is advanced along the guide wire portion 1.

That is, the catheter 8 is pushed in using the outer tube 3 as a guide and guided from the aorta 31 to the renal artery 32.

Then, when the tip of the catheter 8 has been introduced into the renal artery 32, the guide wire portion 1 is pulled out from the catheter 8, and a medical solution such as a contrast medium is injected through the catheter 8.

According to the configuration of the above embodiment, the straightening pipe 4
By simply moving the guide wire forward and backward, the distal end portion 12 of the guide wire portion 1 can be freely bent, and the amount of bending can also be adjusted.

Furthermore, since the core wire 5 is bent by utilizing its bending characteristics, the distal end portion 12 of the guide wire portion 1 can be bent by 90° or more.

Moreover, since it is not necessary to apply a large force to the operation by simply moving the straightening pipe 4 forward and backward, it is easy to operate and can be used safely without the possibility of parts being cut.

Further, according to the above configuration, the straightening pipe 4 can be pushed forward or pulled back along the core line 5, and the straightening pipe 4 can be
By moving the guide wire 1, the bending angle of the tip of the guide wire 1 can be arbitrarily changed.However, in this case, the position of the tip of the guide wire 1 must not change as the straightening pipe 4 is moved. .

This is because, if an attempt is made to bend the tip of the guide wire 1 in a desired direction at a branch point of a blood vessel, the tip of the guide wire 1 will be misaligned and the guide wire 1 will not be able to be bent and advanced in a predetermined direction.

Here, suppose that the guide outer tube 3 in the above configuration is (
, if it is made up of only the core wire 5 and the straightening pipe 4, it is possible to push the straightening pipe 4 along the core wire 5, but it is possible to leave the core wire 5 behind, that is, to change the position of the tip of the guide wire 1. strange.

It is impossible to pull back only the straightening pipe 4 without moving it.

However, in the present invention, the guide outer tube 3 is particularly fitted on the outside of the straightening pipe 4, and the core wire 5 and the guide outer tube 3 are fixed at the tip, so that the guide wire can be attached even when the straightening pipe 4 is pulled back. , the position of the tip of the ear 1 can be held so that it does not move.

Therefore, the distal end of the guide wire 1 can be correctly bent at any angle at a fixed position.

In addition, in the above embodiment, the strike 4 collar 1 of the straightening pipe 4
0 hits the outer guide tube 3, the tip of the straightening pipe 4 is positioned leaving the most distal end 11 as shown in FIG. Do not damage blood vessel walls.

In the one shown in FIG. 9, a small coil spring 34 is bonded to the distal end portion 28 of the orthodontic pipe 4 to strengthen the stiffness.

For example, if the length of the flexible tip portion 11 is desired to be 30 m1, a small coil spring 34 having a length of about 20 mm from the tip portion 28 of the straightening pipe 4 is provided.

This makes it possible to increase the length of the flexible tip portion 11, making it suitable for cases where the curvature of the blood vessel is large.

As explained above, according to the present invention, the bending angle of the tip can be made large and the bending can be performed reliably at the same position.

Furthermore, the bending operation does not require a large operating force and can be used easily and safely.

The present invention is not limited to insertion into renal arteries, but also facilitates insertion into cerebral vessels, coronary arteries, and other complex blood vessel branch sites, and is useful for selective angiography, local drug treatments, local blood sampling, etc. It can also be used for

[Brief explanation of the drawing]

Fig. 1 is a perspective view showing the entire embodiment of the present invention, Fig. 2 is a cross-sectional view of a part of the guide wire of the same embodiment, and Fig. 3 is a cross-section of a part of the guide wire of the same embodiment in a bending operation state. 4 is a rear view showing the proximal end of the core wire of the same embodiment, FIG. 5 is a sectional view showing the operating section of the same embodiment, and FIG. 6 is a side view of the operating section of the same embodiment. FIG. 7 is a rear view of the operating section of the same embodiment, FIG. 8 is a state diagram of a portion of the guide wire inside a blood vessel, and FIG. 9 is a sectional view of the distal end of a portion of the guide wire of another embodiment. 1... Part of the guide wire, 2... Operation section, 3... Outer tube, 4... Straightening pipe, 5... Core wire, 6... Coil spring, 7... Material, 8... Catheter,
9... Tip member, 10... Stopper,
11... Cutting edge part, 12... Tip part, 13... Tip part, 14... Engaging piece,
15... Operating unit main body, 16... Front end, 17... Fastening cap, 18...
Tip, 19...Through hole, 20...Male thread, 21...Female thread, 22...Through hole, 23... Elastic ring, 24...Round lock (registered trademark), 25...Tapered portion, 26...Engaging portion, 27...Engaging protrusion, 28・・・・・・Tip.

Claims (1)

[Scope of Claims] 1. When introducing a catheter into a tubular body cavity that branches in the middle, the guide wire that guides the catheter has an outer diameter that can be inserted into the catheter, and at least the distal end is bendable. A guiding outer tube configured, a straightening pipe inserted into the outer tube so as to be freely advanced and retractable, and a straightening pipe inserted into the straightening pipe and having its tip fixedly attached to the tip of the guiding outer tube. Along with providing a core wire,
A guide wire for a catheter, wherein the distal end of the core wire has a characteristic of curving and is equipped with a hand operation section for advancing and retracting the correction pipe. 2 The above guide outer tube is a tightly wound elastic coil spring. The guide wire 0 of the catheter according to claim 1, characterized in that the guide wire 03 is formed from a guide wire 03 of the catheter according to claim 1, wherein the guide wire 03 is formed of a guide wire 03 of the catheter according to claim 1, wherein the guide wire 03 is formed of a guide wire 03 of the catheter described in claim 1. The present invention is characterized by being provided with a stopper that hits a member other than the pipe and prevents it from moving forward, thereby leaving a flexible leading edge portion extending from the tip of the straightening pipe at the tip of the outer guide tube. A guide wire for a catheter according to claim 1. 4. The guide wire for a catheter according to claim 1, wherein a reinforcing coil spring is inserted inside the flexible leading end portion of the outer guiding tube.